Senior Claims Adjudicator - US Health Care - Bangalore

4 - 8 years

4 - 5 Lacs

Posted:3 weeks ago| Platform: Naukri logo

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Job Type

Full Time

Job Description

Roles and Responsibilities :

  • Review and process claims in accordance with established guidelines, regulations, and company policies.
  • Conduct thorough reviews of medical records, diagnoses, treatments, and procedures to determine coverage eligibility.
  • Identify potential denials and take proactive steps to resolve issues before submitting claims to payers.
  • Collaborate with internal stakeholders to ensure accurate coding, billing, and reimbursement processes.

Job Requirements :

  • 4-8 years of experience in claims adjudication or related field (e.g., HCPCS).
  • Strong understanding of ICD-10-CM/PCS, CPT, HCPCS codes; ability to apply knowledge effectively.
  • Proficiency in claims processing software applications such as Epic Systems or similar systems.
  • Excellent analytical skills for reviewing complex medical data and making informed decisions.

Interested candidate can share updated resume to brindha@gojobs.biz

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